多牙缺失患者计算机导板应用下种植术后误差研究  

Research of computer-aided design surgical template operation accuracy in multi-anodontia patients

作　　者：赵毅[1] 张晓真[1] 汤春波[1] 

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院种植科,江苏南京210029

出　　处：《口腔医学》2016年第3期214-218,共5页Stomatology

基　　金：国家自然科学基金(81470778);江苏高校优势学科建设工程资助项目(2014-37)

摘　　要：目的评价分析计算机辅助设计和制作种植导板应用于多牙缺失患者的种植术后误差。方法选择多牙缺失患者20例,采集CT数据,利用彩立方Tooth Implant软件进行数据分析,拟定植入位点及确定手术计划并制作最终导板。口内戴入导板,植入种植体,选用相应型号的即刻修复基台,术后48 h内戴入即刻修复体。并于术后拍摄CT,测量术前、术后种植体在颌骨内的深度、近远中向及唇舌向的倾斜角度,计算术后误差,3个月后完成最终义齿修复。于修复后3个月、6个月及1年后评价种植体存留率。结果 20例多牙缺失患者共植入139枚种植体,种植体植入位置精确性好,观察期内有2枚种植体脱落,其余137枚种植体牙周软组织健康,无种植体周围炎发生。结论应用计算机辅助设计和制作的种植导板对于提高种植手术的质量与精度具有重要意义,可以指导临床医生植入种植体时避免伤及重要解剖结构,即刻修复极大地改善了患者术后生活质量,但仍需进一步跟踪观察其长期应用效果。Objective To evaluate the application of computer aided design computer aided manufacturing（ CAD / CAM） surgical template to measure the operation error in multi-anodontia patients. Methods A total of 20 multi-anodontia patients were selected and their CT DICOM data were analyzed by the E-Feature Tooth Implant Client was used to design the locus and determine the implant surgery plan. Guide plate and implant were put intraorally,then immediate repair base in a corresponding size was selected,and immediate restoration was put in the patient＇s mouth 48 h after the surgery. At the same time,patients took CT for the measurement of the depth of the implants in the jaw,the angle of mesio-distally direction and faciolingual inclination of implants to see the operation error and observe the survival rate of the implants in the 3^rd month,6^th month and one year. Results A total of 139 implants of 20 patients had accurate locations and only 2 implants fell off during follow-up. The gingival tissues of other 137 implants were in healthy condition with no periimplantitis occurring. Conclusion Computer aided design computer aided manufacturing surgical template and immediate loading can improve the accuracy of implants＇ locations and give dentists guidance. However,their long term effects need to be confirmed by further follow-up.

关 键 词：计算机辅助种植 即刻负重 手术导板 3D快速成型技术 

分 类 号：R783.4[医药卫生—口腔医学]